Raven Rescue

Register for Swiftwater - Technician (SRT I)

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* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Drysuit - 2 Days ($40/day)

PFD (no charge)

Helmet (no charge)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Swiftwater - Technician (SRT I)

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Drysuit - 2 Days ($40/day)

PFD (no charge)

Helmet (no charge)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Swiftwater - Operations

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Drysuit - 2 Days ($40/day)

PFD (no charge)

Helmet (no charge)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Swiftwater - Technician (SRT I)

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Drysuit - 2 Days ($40/day)

PFD (no charge)

Helmet (no charge)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Technical Rope Rescue - Technician

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Helmet (no charge)

Harness - 4 Days ($25/day)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Technical Rope Rescue - Operations

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Helmet (no charge)

Harness - 2 Days ($25/day)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Swiftwater - Technician (SRT I)

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Drysuit - 2 Days ($40/day)

PFD (no charge)

Helmet (no charge)

Harness - 2 Days ($25/day)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Swiftwater - Operations

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Drysuit - 1 Day ($40/day)

PFD (no charge)

Helmet (no charge)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Swiftwater - Technician (SRT I)

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

PFD (no charge)

Helmet (no charge)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Swiftwater Operations

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Drysuit - 1 Day ($40/day)

PFD (no charge)

Helmet (no charge)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Swiftwater - Technician (SRT I)

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Drysuit - 2 Days ($40/day)

PFD (no charge)

Helmet (no charge)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Technical Rope Rescue - Operations

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Helmet (no charge)

Harness - 2 Days ($25/day)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Technical Rope Rescue - Technician

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Helmet (no charge)

Harness - 4 Days ($25/day)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Swiftwater - Technician Advanced (SRT A)

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Drysuit - 2 Days ($40/day)

PFD (no charge)

Helmet (no charge)

* Size

I will bring my own gear

+ Add Another Registrant

Register for Swiftwater - Technician (SRT I)

Fields marked with * are required

* Start Date:

* End Date:

* Location:

Contact Person

Please click here if you are submitting registration(s) for others.

Please complete the following:

Name:

Title:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

Email:

Phone #:

Fax #:

Address:

City:

Province/State:

Postal Code:

Registrant #1

Personal Information

Mailing info same as above

* First Name:

* Last Name:

* Email:

* Phone #:

Company / Organization:

GST Exempt?

(Provincial governments and First Nations)

* Address:

* City:

* Province/State:

* Postal Code:

1st Time or Recert?

Year of Certification

Gear Rental

I need rental gear

Check the box beside each item required.

Drysuit - 2 Days ($40/day)

PFD (no charge)

Helmet (no charge)

* Size

I will bring my own gear

+ Add Another Registrant